Depressive symptoms among Mexican Americans: a three-generation study

The distribution of depressive symptoms and rates of high depressive symptomatology are examined with data from a three-generation study of 1,074 Mexican Americans conducted in San Antonio, Texas, during 1981 and 1982. The purpose of this analysis is to contribute to the available data on the mental health status of Mexican Americans as well as to compare the effects of several relevant sociodemographic factors on prevalence of depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale in different generations. In general, previous findings with respect to the associations between sociodemographic variables and depressive symptoms are replicated, although this sample of Mexican Americans experiences comparatively low levels of depressive symptoms, particularly among males. However, the results indicate that interaction effects may exist between generations and other relevant variables typically found to be related to distribution of depressive symptoms in the general population.     

Migration intentions among Portuguese junior doctors: Results from a survey

Migration of health personnel during periods of economic crisis represents a challenge for policymakers in origin and destination countries. Portugal is going through a period of economic hardship and much has been speculated about an increase in junior doctors’ migration during this period. Using a questionnaire administered to a sample of Portuguese junior doctors who were still in the general residency (1st-year after medical school), we aim at determining the prevalence of migration intentions among Portuguese junior doctors and to identify the most important drivers of career choice for those who are considering emigrating in the near future. In our sample, 55% of Portuguese junior doctors are considering working abroad in the coming 10 years. Several variables were associated with an intention to work abroad: female sex (odds ratio [OR] 0.559; 95% confidence interval [CI] 0.488–0.640), the National Medical Exam score (OR 0.978; 95% CI 0.961–0.996;), having studied abroad (OR 1.756; 95% CI 1.086–2.867) and considering income and research opportunities as key factors for future specialty choice (OR 1.356; 95% CI 1.132–1.626; OR 2.626; 95% CI 1.228–4.172).Our study warns of the shortages the country may face due to doctors’ migration and the main factors behind migration intentions in Portugal. Developing physician retention strategies is a priority to appropriately address these factors.     

Cardiopulmonary resuscitation: a survey of standards among junior hospital doctors

The theoretical knowledge of cardiopulmonary resuscitation of 50 junior hospital doctors was examined, and an attempt made to assess their practical ability to manage a collapsed patient. Major defects were found in both the doctors' theoretical knowledge and their practical abilities. Only 8% were able to manage a cardiopulmonary arrest adequately. Suggestions are made as to how standards might be improved.     

Gender differences in health expenditure determinants: A follow-up study

Researchers' aim was to investigate if patients/physicians characteristics could differently affect males/females health care expenditure.

In 2009/2010, a health-related-quality-of-life (HRQL) measure was distributed to 887 general practitioners' (GP) patients in Siena's province-Italy. Severity of diseases was calculated through Cumulative Illness Rating Scale Severity Index (CIRS-SI). Information about GPs' gender and age and patients' gender, age, and socio-economic variables were recorded. 2012 data about pharmaceutical, outpatient and hospital expenditure were obtained. Multivariate regression was carried out.

In males, hospital expenditure increased with higher CIRS-SI and female GP whilst in females it was not influenced by any of the variables. Outpatient and pharmaceutical expenditure increased with aging, higher CIRS-SI, and lower HRQL and education, both in males and females.

Gender differences in health expenditure determinants emerged for hospital expenditure.     

Allergen and dust exposure as determinants of work-related symptoms and sensitization in a cohort of flour-exposed workers; a case-control analysis

OBJECTIVES: To estimate the incidence of specific IgE sensitization and allergic respiratory symptoms among UK bakery and flour mill workers; and to examine the roles of flour aeroallergen and total dust exposures in determining these outcomes. METHODS: A cohort of 300 new employees, without previous occupational exposure to flour, were followed prospectively for a median (range) of 40 (1-91) months. Cases-defined as those developing work-related symptoms or a positive skin prick test to flour or alpha-amylase during follow up--were compared with controls, matched for duration of employment. Exposures to flour aeroallergen and total inhalable dust were estimated using a questionnaire and personal sampling techniques. RESULTS: Incidence rates for work-related eye/nose and chest symptoms were 11.8 and 4.1 cases per 100 person years (py), respectively. Fewer employees developed positive skin prick tests to flour (2.2 cases per 100 py) or alpha-amylase (2.5 cases per 100 py). Positive skin tests to occupational allergens were more common among those with new work-related symptoms. There were clear relationships between the risks of developing work-related symptoms or a positive skin prick test and three categories of estimated exposure to total dust or flour aeroallergen. Atopic employees were more likely to develop a positive skin prick test-but not work-related symptoms. These findings were unaffected by age, sex or cigarette smoking. CONCLUSIONS: In this population, many work-related symptoms which develop after first employment in modern UK bakeries or flour mills were not accompanied by evidence of IgE sensitization to flour or alpha-amylase. Although average dust exposures were within current occupational standards, the risks of development of upper and lower respiratory symptoms and of specific sensitization were clearly related to total dust and/or flour aeroallergen exposure. The incidence of work-related chest symptoms in the presence of a positive skin test to flour or alpha-amylase in this setting was approximately 1 case per 100 py.     

Intern discussion group: a supportive educational experience for junior doctors.

The intern year is often a very demanding and stressful experience. To support the interns in a New Zealand hospital, a facilitated weekly discussion group was set up. The group's main goals were to provide training in the management of personal and professional stress while encouraging frank and open discussion. It proved to be a supportive and valuable learning experience for the interns. A similar format could be beneficial for senior hospital doctors.     

Cardiopulmonary resuscitation: attitudes and perceptions of junior doctors

Many junior doctors feel cardiac arrests are unsatisfactorily managed and experience high levels of stress during the procedure, often feeling they are inadequately trained for the task. Juniors also regard 'do not resuscitate' orders as decisions for teams, not individuals.     

One hundred alcoholic doctors: a 21-year follow-up

I read with great interest the article by Lloyd (2002) entitled‘One     

One hundred alcoholic doctors: a 21-year follow-up

AIMS: This paper reports the long-term recovery rate among 100 alcoholic doctors over a 21-year period. Included are 20 doctors who relapsed and re-recovered, 10 who died of non-alcohol related causes and eight who died of alcohol-linked causes. Also reported are abstinence, attendance at self-help group meetings, mortality and employment. METHODS: Selected doctors were the first 100 consecutive alcoholic doctors to become members of the North West Doctors and Dentists Group (NWDDG) between 1980 and 1988. Information sources combine prospective data obtained from each doctor at the time of first contact with the results of questionnaires distributed in 1988 and 2001 and continuing prospective reporting of mortality by relatives. RESULTS: There is a 9% incidence of oral or oesophagopharyngeal cancer. Reported mortality, mostly by relatives, revealed that 24 doctors died directly of their alcoholism. We observed a 73% recovery rate for a 17-year average duration, over a 21-year period. Comparison of recovery with abstinence showed a strong correlation. For the first 6 months of recovery, there was also a strong relationship between recovery and attending meetings of self-help groups. This relationship is not sustained in the long term, though 14 doctors with an average recovery of 20 years still attend meetings regularly. Of 56 doctors currently known to have survived, 29 have retired and 27 are still working as doctors. Three doctors have been drinking normally for an average of 17 years.     

Effect of work-related events on depressive symptoms in Japanese employees: a web-based longitudinal study

While a number of work-related events have been proposed as risk factors for depression, a majority of studies have focused only on a few events in a single study. Therefore, we conducted a web-based longitudinal study to comprehensively investigate the impact of various work-related events on depressive symptoms. Ten thousand Japanese workers representing the Japanese working population were recruited online and questioned on their experiences of 36 work-related events in the past year. Their depressive symptoms were also assessed based on the Center for Epidemiologic Studies Depression Scale. Two years later, 3,098 participants responded to a follow-up study. By excluding 1,030 participants who were classified as being depressed in the baseline survey, data of 2,068 participants were analyzed. Odds ratios (OR) were calculated using multivariate logistic regression to assess the effect of work-related events on depressive symptoms. Sixteen events were found to be risk factors and were sorted into four types as follows: experience of an accident or disaster (OR: 4.78–7.67), excessive responsibility (OR: 3.01–3.62), drastic change in workstyle or workload (OR: 2.38–3.08), and interpersonal conflict (OR: 2.41–11.16). The current results, including magnitude relationship of ORs, should be utilized for promoting psychosocially healthy work environment.     

初中教育阶段流动儿童心理健康影响因素队列研究

目的  分析初中教育阶段流动儿童心理健康的总体状况、变动趋势以及影响因素。 方法  各期资料均来源于中国教育追踪调查。2013-2014学年基线调查采用分层次、多阶段、与规模成比例的概率抽样方法,全国初中教育阶段10 279名七年级学生进入调查队列,2014-2015学年一期追访到9 449人,选取其中1 645名流动儿童作为分析对象。基于调查问卷中的学生自报心理健康量表,采用t检验方法和多元线性回归模型开展流动儿童心理健康的单因素分析和多因素分析。 结果  1 645名初中教育阶段流动儿童的基线心理健康总体得分为(8.33±3.31)分,比非流动儿童得分(8.03±3.17)高,随时间推移到追踪期升高至(8.60±3.79)分,43.3%的被调查者更高频地出现消极心理状态。性别、认知水平、居住方式、兄弟姐妹数量以及学校排名等对心理健康总体得分产生的影响差异具有统计学意义(均有P < 0.05)。 结论  流动儿童心理健康状况相对于非流动儿童更加脆弱,且有持续恶化趋势。流动儿童中的女性、认知能力较弱者、不与父母双方同住者、非独生子女以及所在学校排名中等及以上者心理健康状况偏差。